Outcomes for pediatric liver retransplantation from living donors

Ogura, Yasuhiro; Kaihara, Satoshi; Haga, Hironori; Kozaki, Koichi; Ueda, Mikiko; Oike, Fumitaka; Fujimoto, Yasuhiro; Ogawa, Kohei; Tanaka, Kōichi

doi:10.1097/01.tp.0000080068.22576.3b

Cited by 32 publications

(34 citation statements)

References 19 publications

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“…Previous single center and multicenter studies have revealed patient survival at one yr after retransplantation from 47% to 82%. This is decidedly inferior to that reported for primary LT (1–14). Owing to the scarcity of donor organs, hepatic retransplantation especially in pediatrics has generated significant ethical discussion regarding maximization of hepatic donor utilization.…”

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confidence: 62%

Liver retransplantation in children: The Atlanta experience

Heffron

Pillen

Smallwood

et al. 2010

Pediatric Transplantation

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Liver retransplantation is routinely offered at our institution. Previous reports document that patient and graft survival is significantly less after pediatric rLT compared to primary LT. This has engendered intense debate regarding optimal allocation of organs. Here, we examine our program's approach to pediatric hepatic retransplantation related to patient factors affecting outcomes. Between 1997 and 2009, 272 LTs were performed in 234 patients (mean survival 1994 +/- 1367 days) at our center. Thirty-four patients required rLT including 10 who received their primary transplant elsewhere and four who required two retransplantations. Patient survival did not differ significantly between rLT and LT at one and three yr (p = 0.56). Graft survival between rLT and LT was also similar (p = 0.606) at one and three yr. No significant difference in graft or patient survival was noted between: Patients retransplanted <30 days after LT vs. those >30 days (p = 0.152); patients transplanted with technical variants vs. whole grafts (p = 0.966); technical variants utilized for LT vs. rLT (p = 0.713); rLT recipient age (< or >5 yr; p = 0.298); or ABOI for rLT and LT (p = 0.650). Retransplantation should be offered to optimize pediatric recipient survival after LT and offers similar survival as primary transplant.

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confidence: 62%

Liver retransplantation in children: The Atlanta experience

Heffron

Pillen

Smallwood

et al. 2010

Pediatric Transplantation

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“…In fact, at some centers, LDLTs are the preferred option for that age group (1). And while surgery per se has been associated with some risk and morbidity for the donors, LDLTs for pediatric recipients have been well accepted by the transplant community and general public (2,3). Adult-to-adult LDLTs, a newer and larger procedure, are gaining popularity.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Surgical Outcomes and Quality of Life Surveys in Right Lobe vs. Left Lateral Segment Liver Donors

Humar

Carolan

Ibrahim

et al. 2005

American Journal of Transplantation

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“…19 Taking into consideration the recipient mortality rate of 54.4% observed in the present study, it is necessary to determine clear indications and limitations for revision living-donor liver transplant to avoid morbidity and mortality in potential living-donor candidates.…”

Section: Discussionmentioning

confidence: 90%

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2015

Exp Clin Transplant

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Objectives: Liver transplant is an established curative therapy for children with chronic end-stage liver disease or acute liver failure. In this study, we aimed to evaluate pediatric liver transplant in terms of outcomes, complications, and long-term followup results. Materials and Methods: Pediatric patients who had liver transplant in our institution were included. We retrospectively evaluated demographic features including body weight, Child-Pugh score, etiology of liver disease, graft source, perioperative outcomes, perioperative complications, postoperative complications, and long-term results. Outcomes of treatment of complications and revision transplant were evaluated. Results: Between September 2001 and December 2013, there were 188 pediatric liver transplants performed in our institution. Most grafts (90.9%) were obtained from living-related donors. There were 13 patients (6.9%) who had an intervention because of a hemorrhage postoperatively. Biliary leakage was observed in 33 patients (17.5%) and biliary stricture during follow-up was observed in 32 patients (17%). Thrombosis rates in the hepatic artery and portal vein were 12.3% and 0.5%. Revision transplant was performed in 11 patients (5.8%); reason for revision transplant was rejection in 50% patients. The remaining children were alive with good graft functioning after treatment of complications and revision transplant. The overall 5-and 10-year survival rates were 82.3% and 78.9%. Conclusions:The overall outcomes of pediatric liver transplant at our center are very promising. With improved care of younger children and the combined efforts of the parents and medical team, the number of the children receiving transplants will increase in the future.

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Outcomes for pediatric liver retransplantation from living donors

Abstract: Re-LDLT can save patients with a failing allograft. To achieve better results after Re-LDLT, further investigations are necessary to understand the factors leading to poor outcome after Re-LDLT.

Cited by 32 publications

References 19 publications

Liver retransplantation in children: The Atlanta experience

Liver retransplantation in children: The Atlanta experience

A Comparison of Surgical Outcomes and Quality of Life Surveys in Right Lobe vs. Left Lateral Segment Liver Donors

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